Allocation Of Scarce Resources Research Articles

The Regional Firm Density and the Growth of Firms in the Portuguese Textile and Clothing Industry

This paper focuses on the relationship between the regional firm density and the growth of firms in the Portuguese textile and clothing industry to investigate how their geographic clustering influences said growth. Despite the concentration of this industry in the Northern region of Portugal in only four poles, our results show that the location of firms in the cluster is not relevant for growth when the whole industry is considered. However, disaggregate analysis shows that the clothing industry does exhibit both location externalities and cross-location effect, while textile manufacture exhibits neither. In addition, our empirical evidence reveals that the growth of firms located in the cluster is positively correlated with external finance. This result suggests that location becomes a solvency signal for firms, and, specifically, this might help to explain why textile manufacturers firms are located in the cluster. These findings are relevant for entrepreneurs and Portuguese policymakers, as it jeopardizes the optimal allocation of scarce resources in the Portuguese textile cluster.

Water Pricing and Quotas: A Quantitative Analysis from a Private and Social Perspective

AbstractThe current situation of structural water scarcity due to the rise in demand, the reduction in supply as a consequence of climate change, increasingly frequent drought periods, and overall quantitative pressure on water resources creates a need for economic instruments to reduce the amount of water used, especially in the agricultural sector. Thus, water pricing and allocation quotas (proportional reduction of allocations) may be suitable tools to reduce demand or allocate scarce water resources. For a comparative analysis of the performance of these two measures, a Positive Mathematical Programming model has been developed, using the Guadalquivir River Basin as a case study. Additionally, the analysis takes into account the revenue generated from water pricing and the marginal cost of public funds. The results indicate that, from the farmer’s perspective, quotas result in smaller losses than water pricing. However, when considering water pricing along with the revenue generated from this measure, this mechanism would be more beneficial for society as a whole, since the taxes collected could be used for other purposes, albeit with efficiency losses measured by the marginal cost of public funds and the excess burden of taxation.

Behind the Scenes: Facilitators and Barriers to Developing State Scarce Resource Allocation Plans for the COVID-19 Pandemic

In response to COVID-19, many states revised, developed, or attempted to develop plans to allocate scarce critical care resources in the event crisis standards of care were triggered. No prior analysis has assessed this plan development process, including whether plans were successfully adopted. How did states develop or revise scarce resource allocation plans during the COVID-19 pandemic and what were the barriers and facilitators to their development and adoption at the state level? Plan authors and state leaders completed a semi-structured interview February to September 2022. Interview transcripts were qualitatively analyzed for themes related to plan development and adoption according to the principles of grounded theory. Thirty-six participants from 34 states completed an interview, from states distributed across all U.S. regions. Among participants' states with plans that existed prior to 2020 (n=24), 17 were revised and adopted in response to COVID-19. Six states wrote a plan de novo, with the remaining states failing to develop or adopt a plan. Thirteen states continued to revise their plans in response to disability or aging bias complaints or to respond to evolving needs. Many participants expressed that urgency in the early days of the pandemic prevented an ideal development process. Facilitators of successful plan development and adoption include: coordination or support from the state department of health and existing relationships with key community partners, including aging and disability rights groups and minoritized communities. Barriers include: lack of perceived political interest in a plan and development during a public health emergency. To avoid repeating mistakes from the early days of the COVID response, states should develop or revise plans with community engagement and consider maintaining a standing committee with diverse membership and content expertise to periodically review plans and advise state officials on pandemic preparedness.

To what extent do lay people and healthcare providers differ in the allocation of scarce medical resources in the context of the COVID-19 pandemic?

Studying the most ethical way to allocate scarce medical resources has been of interest within the last year, due to shortages associated with the COVID-19 pandemic. This study aimed to establish differences between what healthcare providers (HCP) and laypeople consider to be the most ethical way to prioritise the distribution of scarce resources. Healthcare providers ( n = 100) and laypeople ( n = 102) were asked to rank ethical principles from most to least ethical for the allocation of ICU beds in a COVID-19 outbreak, COVID-19 vaccinations and organ transplantation, and the rankings from each scenario across the two groups were compared. Results indicated that HCPs preferred utilitarian principles informed by medical knowledge, such as ‘prognosis’, whereas laypeople preferred less situation-specific and prioritarian principles, such as ‘sickest first’, replicating pre-pandemic findings. Laypeople showed increased in-group agreement when ranking principles, potentially due to the collective experience of the pandemic. Demographic variables such as older age, identifying as Black, Asian or minority ethnic and greater experience with COVID-19, were also associated with a preference for ‘prognosis’.

COVID-19 critical care triage across Canada: a narrative synthesis and ethical analysis of early provincial triage protocols.

The COVID-19 pandemic created conditions of scarcity that led many provinces within Canada to develop triage protocols for critical care resources. In this study, we sought to undertake a narrative synthesis and ethical analysis of early provincial pandemic triage protocols. We collected provincial triage protocols through personal correspondence with academic and political stakeholders between June and August 2020. Protocol data were extracted independently by two researchers and compared for accuracy and agreement. We separated data into three categories for comparative content analysis: protocol development, ethical framework, and protocol content. Our ethical analysis was informed by a procedural justice framework. We obtained a total of eight provincial triage protocols. Protocols were similar in content, although age, physiologic scores, and functional status were variably incorporated. Most protocols were developed through a multidisciplinary, expert-driven, consensus process, and many were informed by influenza pandemic guidelines previously developed in Ontario. All protocols employed tiered morality-focused exclusion criteria to determine scarce resource allocation at the level of regional health care systems. None included a public engagement phase, although targeted consultation with public advocacy groups and relevant stakeholders was undertaken in select provinces. Most protocols were not publicly available in 2020. Early provincial COVID-19 triage protocols were developed by dedicated expert committees under challenging circumstances. Nonetheless, few were publicly available, and public consultation was limited. No protocols were ever implemented, including during periods of extreme critical care surge. A national approach to pandemic triage that incorporates additional aspects of procedural justice should be considered in preparation for future pandemics.

Entrectinib as first-line vs. second-line therapy in ROS1 fusion-positive non-small cell lung cancer: a cost-effectiveness analysis.

The concept of cost-effectiveness is crucial for the optimal allocation of scarce healthcare resources. However, the cost-effectiveness of entrectinib in ROS1 fusion-positive non-small cell lung cancer (NSCLC) has not been evaluated. We aim to evaluate the cost-effectiveness of entrectinib as a first-line treatment compared to its reservation for second-line therapy or the exclusive use of chemotherapy in ROS1 fusion-positive advanced NSCLC. A Markov model was created to assess the clinical outcomes and healthcare costs associated with these three treatment approaches. Cost and utility values were obtained from established literature and cost databases. To test model robustness, probabilistic and univariate sensitivity analyses were conducted. In the first-line setting, where entrectinib was administered as the initial therapy, it yielded an extra 0.07 quality-adjusted life years (QALYs) at an incremental cost of $73,453, leading to an incremental cost-effectiveness ratio (ICER) of $1,090,594.30 per QALY compared to chemotherapy. Conversely, in the second-line setting, when entrectinib was used as a second-line therapy following chemotherapy, it provided an extra 0.11 QALYs at an incremental cost of $53,480, resulting in an ICER of $494,290.39 per QALY compared to chemotherapy. Furthermore, the analysis revealed that the cost of entrectinib and utility values of progressed disease were the most influential factors for the ICER. Considering the current pricing of entrectinib, it is not deemed cost-effective as a first-line or second-line therapy for patients with ROS1 fusion-positive advanced NSCLC when compared to chemotherapy. Alternatively, reserving entrectinib exclusively for second-line therapy might strike a balance between healthcare expenditures and patient outcomes.

AI 거버넌스의 정의와 쟁점 및 발전 과제: 비판적 관점

In the data-driven economy, AI algorithms will eventually drive power interests and value allocation of scarce resources in terms of who gets what, when, and how. However, to date, the decision-making process and internal mechanisms of algorithm-based AI remain “a black box”. Therefore, a critical systematic analysis of the benefits and limitations of AI’s practical utility and applicability, as well as legal and institutional promotion and control measures to enhance transparency in algorithm design, is needed now more than ever. The current structural situation of human oppression, control, and domination by AI power in the name of techno-engineering-based social innovation and development in the age of digital capitalism requires a multidisciplinary approach to governance that utilizes political science, educational politics, and critical theory perspectives. This paper aims to comprehensively review the emerging AI governance definitions, issues, and development plans from critical perspectives.

A survey of the allocation of scarce resources in Türkiye during the COVID-19 pandemic: Which criteria did healthcare professionals prioritize?

COVID-19 caused an imbalance between medical resources and the number of patients in Türkiye like in many countries. There was not pandemic-triage system, and this situation led to decision making based on experience, intuition, and judgment of allocation of scarce resources. The research explains the guiding criteria that healthcare professionals used to prioritize the distribution of scarce medical resources during the COVID-19 pandemic. The criteria preferred by 928 healthcare professionals were evaluated when preventive measures for COVID-19 were reduced and so the number of cases increased rapidly. The results indicate that Turkish healthcare professionals largely support the utilitarian approach, which focuses on medical benefit in pandemic. The main problem was that some criteria not approved in COVID-19 triage guidelines were considered important by healthcare professionals. These criteria, which cause discrimination by preventing the provision of fair and equal medical care to patients, are a prominent issue in the study.

Health Professional vs Layperson Values and Preferences on Scarce Resource Allocation

COVID-19 prompted rapid development of scarce resource allocation (SRA) policies to be implemented if demand eclipsed health systems' ability to provide critical care. While SRA policies follow general ethical frameworks, understanding priorities of those affected by policies and/or tasked with implementing them is critical. To evaluate whether community members and health care profesionals (HCP) agree with SRA protocols at the University of California (UC). This survey study used social media and community-partnered engagement to recruit participants to a web-based survey open to all participants aged older than 18 years who wished to enroll. This study was fielded between May and September 2020 and queried participants' values and preferences on draft SRA policy tenets. Participants were also encouraged to forward the survey to their networks for snowball sampling. Data were analyzed from July 2020 to January 2024. Survey items assessed values and preferences, graded on Likert scales. Agreement was tabulated as difference in Likert points between expressed opinion and policy tenets. Descriptive statistics were tested for significance by HCP status. Free text responses were analyzed using applied rapid qualitative analysis. A total of 1545 participants aged older than 18 years (mean [SD] age 49 [16] years; 1149 female participants [74%], 478 health care practitioners [30%]) provided data on SRA values and preferences. Agreement with UC SRA policy as drafted was moderately high among respondents, ranging from 67% to 83% across domains. Higher agreement with the interim policy was observed for laypersons across all domains except health-related factors. HCPs agreed more strongly on average that resources should not be allocated to those less likely to survive (HCP mean, 3.70; 95% CI, 3.16-3.59; vs layperson mean, 3.38; 95% CI, 3.17-3.59; P = .002), and were more in favor of reallocating life support from patients less likely to those more likely to survive (HCP mean, 6.41; 95% CI, 6.15-6.67; vs layperson mean, 5.40; 95% CI, 5.23-5.58; P < .001). Transparency and trust building themes were common in free text responses and highly rated on scaled items. This survey of SRA policy values found moderate agreement with fundamental principles of such policies. Engagement with communities affected by SRA policy should continue in iterative refinement in preparation for future crises.

Design of innovative processes

Subject. The article deals with allocation of scarce resources, problems of forecasting, risk management. Objectives. The aim is to search for optimal methods of detailed elaboration of strategic objectives, forms of joint participation of scientific and industrial organizations in innovation activities. Methods. The study employs methods of comparative, structural, and logical analysis are applied. Results. Innovative design should take into account the uncertainty of the economic situation. A number of sections of innovation project should be developed in several versions, based on forecasts for the development of target markets. Conclusions. New knowledge is produced out only through the use of human cognitive abilities.

Allocating health care resources in jails and prisons during COVID-19: a qualitative study of carceral decision-makers.

COVID-19 created acute demands on health resources in jails and prisons, burdening health care providers and straining capacity. However, little is known about how carceral decision-makers balanced the allocation of scarce resources to optimize access to and quality of care for incarcerated individuals. This study analyzes a national sample of semi-structured interviews with health care and custody officials (n = 32) with decision-making authority in 1 or more carceral facilities during the COVID-19 pandemic. Interviews took place between May and October 2021. We coded transcripts using a directed content analysis approach and analyzed data for emergent themes. Participants reported that facilities distributed personal protective equipment to staff before incarcerated populations due to staff's unique role as potential vectors of COVID-19. The use of testing reflected not only an initial imperative to preserve limited supplies but also more complex decision-making about the value of test results to facility operations. Participants also emphasized the difficulties caused by limited physical space, insufficient staff, and stress from modifying job roles. The rapid onset of COVID-19 confronted decision-makers with unprecedented resource allocation decisions, often with life-or-death consequences. Planning for future resource allocation decisions now may promote more equitable decisions when confronted with a future pandemic event.

How did European countries set health priorities in response to the COVID-19 threat? A comparative document analysis of 24 pandemic preparedness plans across the EURO region

The COVID-19 pandemic has forced governments across the world to consider how to prioritise the allocation of scarce resources. There are many tools and frameworks that have been designed to assist with the challenges of priority setting in health care. The purpose of this study was to examine the extent to which formal priority setting was evident in the pandemic plans produced by countries in the World Health Organisation's EURO region, during the first wave of the COVID-19 pandemic. This compliments analysis of similar plans produced in other regions of the world. Twenty four pandemic preparedness plans were obtained that had been published between March and September 2020. For data extraction, we applied a framework for identifying and assessing the elements of good priority setting to each plan, before conducting comparative analysis across the sample. Our findings suggest that while some pre-requisites for effective priority setting were present in many cases – including political commitment and a recognition of the need for allocation decisions – many other hallmarks were less evident, such as explicit ethical criteria, decision making frameworks, and engagement processes. This study provides a unique insight into the role of priority setting in the European response to the onset of the COVID-19 pandemic.

Ethical Shortcomings of QALY: Discrimination Against Minorities in Public Health.

Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought.

PROVIDENT: Development and Validation of a Machine Learning Model to Predict Neighborhood-level Overdose Risk in Rhode Island.

Drug overdose persists as a leading cause of death in the United States, but resources to address it remain limited. As a result, health authorities must consider where to allocate scarce resources within their jurisdictions. Machine learning offers a strategy to identify areas with increased future overdose risk to proactively allocate overdose prevention resources. This modeling study is embedded in a randomized trial to measure the effect of proactive resource allocation on statewide overdose rates in Rhode Island (RI). We used statewide data from RI from 2016 to 2020 to develop an ensemble machine learning model predicting neighborhood-level fatal overdose risk. Our ensemble model integrated gradient boosting machine and super learner base models in a moving window framework to make predictions in 6-month intervals. Our performance target, developed a priori with the RI Department of Health, was to identify the 20% of RI neighborhoods containing at least 40% of statewide overdose deaths, including at least one neighborhood per municipality. The model was validated after trial launch. Our model selected priority neighborhoods capturing 40.2% of statewide overdose deaths during the test periods and 44.1% of statewide overdose deaths during validation periods. Our ensemble outperformed the base models during the test periods and performed comparably to the best-performing base model during the validation periods. We demonstrated the capacity for machine learning models to predict neighborhood-level fatal overdose risk to a degree of accuracy suitable for practitioners. Jurisdictions may consider predictive modeling as a tool to guide allocation of scarce resources.

A Call to Duty; but Duty to Who? -: Voices of Healthcare Providers in Conflict Zones.

Serving as a healthcare worker in a conflict zone is an experience that is characterized by peculiar and unimaginable challenges. This commentary is an exposition on twelve collated stories of healthcare providers currently serving or who have previously served in war. The stories bring to bear the heaviness of emotions such as fear and guilt that the authors grappled with, while concurrently showing that they embody virtues such as altruism, self-sacrifice, courage, and solidarity. In these stories, we see highlighted recurrent ethical themes including the tension between the duty to others and the duty to self, prioritization and allocation of scarce health resources, ethics of research in war, ethics of virtue and the lasting effects of war. This commentary thus explores and heightens our awareness of the interplay between personal morals and the translation of these into ethics of healthcare provision in war. In so doing, the commentary urges us to reflect on ways by which we can engage the discourse pertaining to war and healthcare ethics.

De-agrarianisation and re-agrarianisation in patches: understanding microlevel land use change processes in Nepalese smallholder landscapes

ABSTRACT This paper investigates the ongoing reproduction crisis in Nepal. We utilize farmer context-specific actions of ‘hanging in’, ‘stepping out’ and ‘stepping up’ to unpack the pathways of de-activation, de-agrarianisation and re-agrarianisation in four spatially and socially differentiated landscapes. We detail a continuum of land use and labour use intensity, the microlevel variations and repertoires of actions in relation to landscape, shrinking farm sizes, labour shortages, forest expansion and increasing wildlife encroachment. The analysis focuses on specific landscape and social contexts and shows how smallholders are fine-tuning agricultural practices to meet subsistence needs. But account also must be taken of ecological variability and socially differentiated access to land to understand how households allocate labour between different land uses and between farm and off-farm activities. Household survival depends as much on the allocation of scarce labour resources as on that of scarce land. It suggests that household rather than just land has become a key unit of production.

Response to commentary on “Allocation of scarce resources, disability, and parity”

Response to commentary on “Allocation of scarce resources, disability, and parity”

Geostrategic context: bridging alliances in the shadow of Sino-American competition

ABSTRACT The United States, its Allies, and its partners can adapt to the demands of the emerging strategic context by learning lessons from the tumultuous past five years, i.e. the COVID pandemic and related challenges across Western society, deterioration of relations between China and the West, and Russia’s illegal annexation and (re)-invasion of Ukraine. On the one hand, the bridging of alliances should reinforce existing frameworks by widening areas of cooperation across sectors, deepening collaboration in areas like technology transfer and industry, and lengthening the time horizon to plan and execute activities together – with the intent to insulate Western power against the combined strength of Russian and Chinese subversion and aggression. But on the other, policymakers must ruthlessly prioritize the allocation of scarce resources and development of partnerships with like-minded stakeholders.

Where women in agri-food systems are at highest climate risk: a methodology for mapping climate–agriculture–gender inequality hotspots

Climate change poses a greater threat for more exposed and vulnerable countries, communities and social groups. People whose livelihood depends on the agriculture and food sector, especially in low- and middle-income countries (LMICs), face significant risk. In contexts with gendered roles in agri-food systems or where structural constraints to gender equality underlie unequal access to resources and services and constrain women’s agency, local climate hazards and stressors, such as droughts, floods, or shortened crop-growing seasons, tend to negatively affect women more than men and women’s adaptive capacities tend to be more restrained than men’s. Transformation toward just and sustainable agri-food systems in the face of climate change will not only depend on reducing but also on averting aggravated gender inequality in agri-food systems. In this paper, we developed and applied an accessible and versatile methodology to identify and map localities where climate change poses high risk especially for women in agri-food systems because of gendered exposure and vulnerability. We label these localities climate-agriculture-gender inequality hotspots. Applying our methodology to LMICs reveals that the countries at highest risk are majorly situated in Africa and Asia. Applying our methodology for agricultural activity-specific hotspot subnational areas to four focus countries, Mali, Zambia, Pakistan and Bangladesh, for instance, identifies a cluster of districts in Dhaka and Mymensingh divisions in Bangladesh as a hotspot for rice. The relevance and urgency of identifying localities where climate change hits agri-food systems hardest and is likely to negatively affect population groups or sectors that are particularly vulnerable is increasingly acknowledged in the literature and, in the spirit of leaving no one behind, in climate and development policy arenas. Hotspot maps can guide the allocation of scarce resources to most-at-risk populations. The climate-agriculture-gender inequality hotspot maps show where women involved in agri-food systems are at high climate risk while signaling that reducing this risk requires addressing the structural barriers to gender equality.

Allocation of scarce resources, disability, and parity

Allocation of scarce resources, disability, and parity